All the exciting news! I know, I know, birth stories aren’t really that interesting unless you recently had or are having a baby. So I’m going to mostly make this about all the odd differences we experienced here in the UK from deliveries in the US. In America we’ve delivered in one military hospital and 3 civilian hospitals, all in different states and such, so we have had a wide variety of experiences. Here, we delivered in an NHS hospital (National Health Service), but private hospitals are available if you pay for separate insurance or perhaps out-of-pocket. Not exactly sure how that works, so I can’t speak to that, but I think a lot of the medically-concerned differences would still be there either way.
A sprinkling of baby pictures along the way…
Our mother’s helper Stephanie bought him this little British sleeper with red buses and black taxis on it 🙂 Anyway, a few thoughts from during the pregnancy that I may have mentioned in the past:
They never weigh you at your regular appointments. You only see midwives unless you are higher risk, at which point they schedule a few appointments for you along the way with the OB at the hospital (not your local clinic.) They don’t do the routine gestational diabetes test but only give that test if you have certain risk factors. They still only see you every two weeks at the end unless you’re high risk. There’s only a midwife clinic once a week at our local “surgery” as it’s called, and, even at the hospital, only certain days of the week for certain things – so the ante-natal clinic in the OB ward is only on Wednesdays – as is the midwife clinic at my surgery. So if they discover something and want to send you up for another test or something you have to wait til the next Wednesday to get into the next ante-natal clinic. Not very efficient. When you need to go up to the hospital for something, the hospital staff makes appointments for you and then they notify you by phone or mail of your appointment time – I got a letter last Wednesday in the mail saying I had an appointment for bloodwork at the antenatal clinic – -that day, Wednesday, at 9:45am, which is before our mail is delivered. Oh well!
Here I am finally catching up with some email a few hours after the delivery and after getting a nice long shower in finally 🙂 Good thing we brought our own towels (on Karen’s advice – the lady who was coming to watch the children and help out a bit.) They had sort of threadbare, rough, prison-type towels (never been to prison, but I imagine the towels there are like the ones at this hospital.) She also recommended bringing our own baby nappies and pads and such – good thing because every time we needed something, unless a nurse was in the room to bring it to us, there were no extra things like that around like in every place we’ve delivered in the US. Also, she told us to bring snacks (which you might do in America as well,) which was great because the sandwich options weren’t really to John’s liking (egg salad, cheese and butter, or ham and butter – all very British), and of course it was only me being offered any food (usually in the US you can buy extra meals for your spouse, or they give them to you.) The tea and toast was complimentary for both of us and offered right after the delivery, as well as again in the evening (here in the background.)
That’s another difference – we were specifically offered hot drinks or tea and toast a few times, while in the US it would have been iced drinks for sure, and usually juice or soda. Just so funny we were drinking hot tea on July 17 after delivering a baby!! 🙂 I’ll save a quick “birth story synopsis” for the very end so you squeamish types can skip that part more easily, but now for more differences…
Walking in to the hospital to deliver is a bit more complicated here. John could have dropped me off and then parked but I would have had to wait on a bench or stand around, so I opted to walk up from the car with him (the walking also is easier for me during contractions than sitting would be.) We had to pay to park – as you do everywhere around here – then walked up to the front. If he had wanted to wheel me in in a wheelchair, we would have had to put a one pound coin into the slot on the wheelchair release – just like grocery carts are at most stores here. You get your pound coin back when you return the wheelchair. Needless to say, I walked in, even using the stairs because I was afraid of being stuck in the middle of a contraction on the elevator when I could more easily manage on walking up stairs. When we got to the delivery ward, we saw this:
It’s for buying a card to pay for your tv, computer, or phone usage in your hospital room. For real. That’s one of the things I always look forward to about going to the hospital since we don’t have tv in our home normally – flipping through the million cable tv channels in the hours or day after delivery when you’re bored. Here’s what the tv looked like – super tiny with horrible sound.
I was deemed “higher risk” but not “high risk” because of this being my 6th delivery. Another reason is because my blood platelet levels have been low, and they checked them again on admission, and they were still low. This meant my hopes of being in the “birthing center” down the hall with 4 birthing pools were dashed, and I was relegated to the “Delivery Suite” of the OB Ward instead – and their one birthing pool was out of commission. Because of the low platelets, and the supposed limited ability of a uterus to produce strong enough contractions to sufficiently stop the bleeding after birth, they were concerned about a higher risk of losing too much blood afterwards (the uterine contractions are supposed to help close the capillaries inside, and they say research shows after more births, your uterus is less able to do its job. Odd, since other muscles in the body get stronger with use….) This meant I wouldn’t have been allowed in the birthing pools anyway. Oh well.
Because it is said to reduce blood loss by up to 1 Liter in all deliveries (and, or course, in people delivering babies after number 5 they said) they recommend “active third stage management,” meaning a shot in your leg muscle of pitocin right after the baby is delivered – to help make the uterine contractions stronger to help stem blood loss. This is something I’ve never heard recommended in the US. We turned it down, and my blood loss was low, just like with all my births. This was great to them because they had been concerned about my low platelets (and therefore my clotting ability.) BUT THEN they recommended another medical intervention, a drug, also injected into a leg muscle, to thin your blood to help prevent Deep Vein Thrombosis, also something for which I was at a higher risk because it was baby number 6. So they were worried I wouldn’t clot but wanted to thin my blood. I am not sure that they recommend this in the US, but they did not recommend it with deliveries 1-5, so I think the answer is that they do not.
As in several of my US deliveries, they wanted to put a “port” for an IV in my hand (they called it something else) in case I experienced rapid blood loss after delivery and collapsed veins. We have turned this down at the 3 deliveries in the US at which it was pushed as well. Here, they said it was again because it was baby number 6 so I was higher risk. In the US it was common hospital procedure. We say no to it because it is just an added discomfort, and when I’m trying to natural progress through labor, anything making me more uncomfortable is something we reject. My comfort is paramount especially since I am in excellent health. We can totally understand these precautions are based on past emergency situations they have experience, but I think it can safely be said, that, as with other pregnancy-related recommendations, a lot of it is based on worse-case scenarios and on people who are in much poorer health than me – ie, women who did not run two miles the day before delivering haha – but no, seriously, there are lots of people whose uterine muscles probably are a lot weaker with baby number 6 than they were with baby number 1, but I personally am in better shape now than I have been at any time in my life so I think a lot of the extra precautions are unnecessary for me. Plus, we are at a hospital. They are equipped to deal with emergencies, and that’s why we continue to go to them for our deliveries, when home births would certainly be simpler.
There were a lot of things that were different that we liked a lot. When they “checked me” upon admittance to see if I was ready to stay and labor, I was dilated only to 1-2cm. How disappointing after hours of terribly painful contractions that had been 3 minutes apart for the last hour. This part routinely disappoints me – I’m never as far along as I think, and I hate being told that on a regular basis as the labor progresses. They decided to admit me anyway because it was my sixth child, and they thought it would progress quickly based on the strength and length of my contractions. We asked when they would need to be checking me again, and the midwife said it’s “every four-hourly.” We thought maybe we had misheard and asked, “Every hour?” And she said no – it was every four hours! Yippee! “But we probably won’t need to do it again since you’ll have a baby before that,” the midwife said, which was very encouraging despite the “number.” So that’s a huge difference – in American hospitals they are checking you pretty often, especially when you tell them you want to push. I know the reasoning behind it and won’t go into it here, but I think when you’ve labored a few times, you probably know when to push without having to be told you’re “ready” because they “checked” you. I even said to a friend the night before going in that I would love it if I could be checked only once and not again in the labor – and that’s exactly what happened!! 🙂
Another difference is that with each procedure they “offered” and “recommended,” they were very gracious when we turned it down and didn’t try to ask superior to us because they were midwives and doctors. They recognized that this was my body, my delivery, and my baby, that we had done our research, and that we knew how this worked from having had five babies before. At every previous birth it has been a fight to have the labor go our way. They also did not try to put an external monitor on me at any time, even when I was first admitted. In the US every time we go in they strap a two heart rate monitors to your tummy – one for you and one for baby – and monitor you about 10 minutes to hear the heartrates during a contraction. They print out a little monitor strip. Here, even in this “higher risk” OB Ward, they just brought up a little portable monitor and listened to baby’s heartbeat for about a minute. Every so often during labor they did the same thing – while I was in the tub, too. I think in the states the nurses like it that the external monitor keeps going and doesn’t have to be something that they have to come do. It will beep if there’s a problem, so they don’t have to remember to come in and keep checking your baby’s heartrate.
Why do I care about all these seemingly small interventions that I’ve mentioned? It’s just another issue of comfort vs necessity – is it necessary to constantly check for dilation? Probably not in my case. Is it uncomfortable? You bet!!! And it “throws off my groove” – to quote the emperor in “The Emperor’s New Groove.” Making it through labor without drugs is hard, and you need to be free to focus in your own way if it’s medically possible. Same reason I don’t want the external monitor strapped on (it hurts a lot to have something squeezing around your tummy while your uterus is contracting and is an uncomfortable nuisance when it’s not contracting.) We were literally chewed out by the nurse in delivery number five for removing it. Either way, we liked it that they just rolled with things here and didn’t try to argue every point. They also didn’t force me out of the tub saying, “You can’t deliver in the tub,” but said instead – “I guess if you insist on staying in there we can’t make you get out.”
I didn’t want to deliver in a small tub, though, so I got out eventually, and my water broke with the next contraction, meaning baby was coming soon! We walked over to the bed for me to lean over it while I continued to labor standing up, and John beeped the midwife to update her. She came right away and said she’d better put her gloves on! She asked if I was happy to deliver standing up, to which we of course answered that that would be our plan. We delivered number 4 standing up, leaning against the bed, accidentally because there was no one in the room and John ended up catching her. We told them with number five I wanted to stand through the labor, and the nurses were very hesitant, insisting that we make sure the doctor get there in time for such a crazy thing. Even when the OB was there, though, standing up to deliver still seemed very strange to everyone (she told me she had had women deliver standing up before), and when baby number five was born that way, the OB whisked her up and away from me so quickly that the cord ruptured where there had been a knot in it. Big mess. So my point here is that the midwife didn’t care how or where I delivered – so long as I was happy with the set up. I remember clearly with baby number three feeling ready to push while standing up laboring, and they made me get into the bed, insisting they could get it set up in some way for me to be comfortable (hands and knees, using the squat bar, etc), but I was uncomfortable the rest of that labor and vowed never to get in the bed for a labor again (Aside from having to be in bed while being checked for dilation or during the external monitoring period, I have never had to be back in a bed. That’s another reason I don’t like those things – because getting on and off the bed during labor is hard in the midst of contractions and with a 40 week pregnant belly!
Another funny thing. They were cleaning things up and casually asked – Do you want us to package up the placenta for you to take home? I will not comment on this here – I know why people do it, and that it is becoming more common in the states – suffice it to say, having the question posed to us was just really funny at the time 🙂 I think John was pretty appalled 🙂 Now we’re to the best “difference” we saw. Since I had a “normal” delivery, I could have a 6-hour checkout. The baby needed to be okay’d at 6 hours postpartum, and they needed to observe me off and on in that time, but after that we were free to go! No uncomfortable hospital bed for 24-48 hours. No additional babysitting to pay for! Didn’t have to pay for parking longer! No more gross hospital food! At one point they suggested I might need to stay because of a minor thing, and the choices were – a bay with three other mothers and their newborns – or a private room, to the tune of 120 pounds per night. Wow. I speak from the experience of a military wife, whose insurance covers deliveries completely, so the thought of paying about $200 to spend the night in that hospital was pretty crazy to us. We ended up being discharged at 12:30am (just after midnight), after he was born at 5:30pm. Nice!!
This was by far my fastest labor and takes away my commonly used phrase that all my labors are “long and difficult.” I totally credit this to my continued running up to the end. I mean, nothing else comes close to explaining it, since the labors were never much shorter as I went up from 3 to 4 to 5 kids. When they told me I was 1-2cm dilated but they expected I would deliver within 4 hours, I was pretty happy with that estimate, because I still expected another 6-8 hours of labor, as did John. He and I were SO COMPLETELY THRILLED that less than 2 hours after being checked and admitted, we were holding Daniel in our arms. Once I got out of the bath, the midwife put on her gloves with the next contraction and was delivering the baby on the one after that. It wasn’t “easy” by any stretch of the imagination, but, thank the Lord and my Newton running shoes, it was quick!!